Grief and Trauma Intervention (GTI) for Children

About This Program

Target Population:
Children who are experiencing grief and posttraumatic stress

For children/adolescents ages:
7 – 12

For parents/caregivers of children ages:
7 – 12

Program Overview

GTI is designed for children ages 7 to 12 with posttraumatic stress due to witnessing or being a direct victim of one or more types of violence or a disaster, or due to experiencing or witnessing the death of a loved one, including death by homicide. The purpose of the intervention is to improve symptoms of posttraumatic stress, depression, and traumatic grief. The intervention is conducted with children in a group or individual format in 10 sessions of approximately 1 hour with at least one session with the parent. The techniques used in the sessions are grounded in cognitive-behavioral therapy (CBT) and narrative therapy and include narrative exposure to the trauma (through drawing, discussing, and writing), development of an in-depth, coherent narrative while eliciting the child's thoughts and feelings, development of positive coping strategies, and making meaning of losses.

Program Goals

The goals of Grief and Trauma Intervention (GTI) for Children are:

Learn more about grief and traumatic reactions

Express thoughts and feelings about what happened

Decrease posttraumatic stress reactions

Build coping capacity

Essential Components

The essential components of the Grief and Trauma Intervention (GTI) for Children include:

Parent/Caregiver Services

Grief and Trauma Intervention (GTI) for Children directly provides services to parents/caregivers and addresses the following:

Parent of a child who is experiencing posttraumatic stress and grief

Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment:
There is at least one parent-child meeting although additional family sessions (including other family members or just with the parent) can be added as needed.

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational
or provider readiness for Grief and Trauma Intervention (GTI) for Children.

Formal Support for Implementation

There is formal support available for implementation of
Grief and Trauma Intervention (GTI) for Children as listed below:

Consultation throughout the implementation of GTI for Children may be provided as part of the training package.

Fidelity Measures

There are fidelity measures for
Grief and Trauma Intervention (GTI) for Children as listed below:

In the treatment manual, the there is a chapter on adherence to GTI and a fidelity checklist is provided. See Salloum, A. (2015). Grief and trauma in children: An evidence-based treatment manual. New York, NY: Routledge.

Implementation Guides or Manuals

There are implementation guides or manuals for
Grief and Trauma Intervention (GTI) for Children as listed below:

Status — Participants included low-income urban African American child survivors of homicide victims and/or children who have been exposed to violence

Location/Institution:
Children’s Bureau of New Orleans, Louisiana

Summary:(To include comparison groups, outcomes, measures, notable limitations)
This study evaluated the effectiveness of a time-limited psychotherapy group model Project Last [now called Grief and Trauma Intervention (GTI) for Children] to decrease traumatic symptoms among adolescent survivors of homicide victims. Measure utilized was the Child Posttraumatic Stress Reaction Index (CPTS-RI). Results indicate group therapy may be helpful in reducing PTSD symptoms among adolescent survivors of homicide victims. Total Child PTSD Reaction Index scores, as well as scores on two of three symptom clusters, were significantly reduced at the posttest. Limitations include lack of control or comparison group, lack of randomization of participants, and lack of follow-up.

Length of postintervention follow-up:
None.

Salloum, A. (2008).
Group therapy for children experiencing grief and trauma due to homicide and violence: A pilot study. Research on Social Work Practice, 18(3), 198-211.

Status — Participants included low-income urban African American child survivors of homicide victims and/or children who have been exposed to violence

Location/Institution:
Children’s Bureau of New Orleans, Louisiana

Summary:(To include comparison groups, outcomes, measures, notable limitations)
This study utilizes information from a previous study Salloum et al. (2001). This study involved a secondary analysis using data from child group participants’ case records from Children’s Bureau of New Orleans to examine children who participated in the Project LAST [now called Grief and Trauma Intervention (GTI) for Children] elementary-age grief and trauma intervention. Measure utilized was the Child Posttraumatic Stress Reaction Index (CPTS-RI). Results indicate that low-income African American urban children who participated in the school-based grief- and trauma-focused intervention experienced fewer symptoms of posttraumatic stress at the end of intervention primarily in the areas of avoidance and re-experiencing symptoms. Limitations include lack of control or comparison group, lack of randomization of participants, and lack of follow-up.

Summary:(To include comparison groups, outcomes, measures, notable limitations)
This study evaluated a community-based grief and trauma intervention for children, Project Last [now called Grief and Trauma Intervention (GTI) for Children] conducted postdisaster. Children were randomly assigned to two groups: individual treatment and group treatment. Measures utilized include the UCLA Posttraumatic Stress Disorder Index for DSM–IV (UCLA–PTSD-Index), the Mood and Feelings Questionnaire–Child Version (MFQ–C), and the UCLA Grief Inventory–Revised. Results indicate that there was a significant decrease in all outcome measures over time, and there were no differences in outcomes between children who participated in group intervention and those who participated in individual intervention. Limitations include lack of a control group, small sample size, and length of follow-up.

Status — Participants who experienced different types of potentially traumatic events in Hurricanes Katrina and Gustav.

Location/Institution:Not Specified

Summary:(To include comparison groups, outcomes, measures, notable limitations)
This study evaluated the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) [now called Grief and Trauma Invention (GTI) for Children] and coping skills only (C). Participants were randomly assigned to two groups: 1) GTI with coping skills and narrative construction (GTI-CN) and 2) GTI with coping skills (GTI-C) Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures include the Mood and Feelings Questionnaire-Child Version (MFQ-C), the UCLA Posttraumatic Stress Disorder Index for DSM-IV (UCLA-PTSD Index), the Extended Grief Inventory, Multidimensional Scale of Perceived Social Support (MSPSS), the Child behavior checklist (CBCL), and the Things I Have Seen and Heard survey. Results indicate that children assigned to GTI-CN reported expressing their thoughts and feelings more than the GTI-C group, who tended to report learning more ways to cope than children in the GTI-CN group. Additionally, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months postintervention. Limitations include lack of control group, small sample size, and reliability on self-reported measures.

The CEBC is funded by the California Department of Social Services’ (CDSS’) Office of Child Abuse Prevention and is one of their targeted efforts to improve the lives of children and families served within child welfare system.